Individual provider Active NPI

Kelsey Violet Luce, PA-C

  • Physician Assistant
  • Dickinson, ND
National Provider Identifier
1043792476
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0750 Issued in ND
Practice address
2615 Fairway St
Dickinson, ND 58601-2590
Phone
(701) 456-6000
NPI assigned
Sep 1, 2018
Last updated
May 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0750 ND Primary
Physician Assistant 363A00000X NU

Addresses

Primary practice location

2615 Fairway St
Dickinson, ND 58601-2590

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181025002277 ND Practitioner - Physician Assistant 2264785930 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

2615 Fairway St
Dickinson, ND 58601-2590
Phone (701) 456-6000

3318 N 14TH St
Bismarck, ND 58503-1614
Phone (701) 323-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presentation Medical Center CurrentSince Dec 1, 2025 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Sep 11, 2018 Accepting new patients
Sanford Bismarck CurrentSince Jun 9, 2025 Accepting new patients
Presentation Medical Center CurrentSince Dec 1, 2025 Accepting new patients
Jacobson Memorial Hospital Care Center Past Accepting new patients
Presentation Medical Center Past Accepting new patients

Locations

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

2615 Fairway St
Dickinson, ND 58601
Phone (701) 456-6000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1043792476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012590",
            "telephone_number": "701-456-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Fairway St",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "ND",
            "postal_code": "58601",
            "country_code": "US",
            "telephone_number": "701-456-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCE",
        "first_name": "KELSEY",
        "middle_name": "VIOLET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-01",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0750",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

Verify at the official NPI Registry.